It seems that as we get older, it gets harder to shed those few stubborn pounds. Many factors start to work against us – lack of sleep and time, stress, changing hormones. And if you’ve been diagnosed with Polycystic Ovarian Syndrome (PCOS), it can be even more challenging to lose a few. One of the common symptoms of PCOS (though not experienced by all women with PCOS) is weight gain. You may be feeling like you work out like crazy but still don’t see results. When it comes to PCOS, this calls for a tailored diet, a unique workout routine, and extra self-care.
Those with PCOS experience certain hormonal imbalances that lead symptoms such as weight gain, male-pattern baldness, male-pattern hair growth, infertility, acne, mood issues, and irregular periods.
But what, exactly, is the link between PCOS and weight gain? Does one cause the other? Why are some women with PCOS overweight while others are thin?
The Link Between PCOS and Weight Gain
PCOS and Blood Sugar Balance
Nothing makes you want that chocolate chip cookie more than when someone tells you not to eat it, right? Women with PCOS tend to be more prone to insulin resistance. Part of insulin’s job is to get sugar out of the bloodstream and into the cells (read a more thorough explanation of this here). When there is too much sugar in the blood and insulin is chronically high in response, the cells become resistant to insulin. So where does the sugar go if it can’t get into the cells? It gets sent to the liver and converted into excess fat.
But why are gals with PCOS more prone to insulin resistance?
PCOS and Hormones
I wish I could give you an “x+y=z” answer. If you have PCOS, I’m sure you’ve realized by now that PCOS is a complex and often misunderstood condition. The exact causes of PCOS are hard to pinpoint – it could be genetic, it could be related to birth control usage, or it could be lifestyle factors (weight gain, diet, exposure to toxins, exercise). Research suggests that women with PCOS may over-produce insulin in response to sugar in the bloodstream (extra sensitive to sugar).
Besides leading to more fat storage, chronically high insulin often triggers an increase in other hormones like cortisol and androgens (often referred to as male hormones because they are higher in males). An increase in these hormones could lead to more weight gain. What’s more is that weight gain will often exacerbate symptoms of PCOS.
High androgen levels may be caused by hormonal birth control (source), hypersensitive androgen receptors (even with normal androgen levels), inflammation (source), and/or genetics. High androgen levels have been linked to hunger and weight gain (source), as well as symptoms such as acne, excessive face, chest, and back hair, insulin resistance, and ovarian cysts.
PCOS and Impaired Appetite Control
Women with PCOS also seem to have a dysregulation of the hormone ghrelin, which is known as the hunger hormone. Studies show that women with PCOS show less of a reduction in the hunger hormone after eating a meal as well as feeling less satisfied after eating, which may lead to overeating and weight gain (source).
Where to Start
The good news is that losing weight can greatly improve symptoms of PCOS. But it’s not as simple as “eat less, exercise more.” Many women struggle with losing weight as it is. Throw hormonal imbalance into the mix and it’s even tougher. So we must start by balancing hormones and this can take some fine-tuning. But you can start with the following suggestions:
Balance Blood Sugar Levels
Balancing our blood sugar not only minimizes our sugar cravings, but it improves weight, skin health, sleep, mood, and more. You can start first thing in the morning by eating a quality breakfast consisting of quality protein, steamed veggies, and healthy fats like avocado. I’m not saying to deprive yourself of treats – we can strike a balance by eating our favorite goodies in a healthy way
Consider Eliminating Dairy
Dairy is one of those controversial foods that many people have a hard time digesting. It has been linked to inflammation, acne, digestive issues, and insulin resistance (source). Leafy greens, broccoli, legumes, sardines, nuts and seeds have a bounty of calcium.
Be Wary of Fad Diets
There are so many extreme diets out there that promise long-lasting weight loss while eating dessert and sitting in your favorite recliner. Be wary of these as they can send your hormones into a tizzy. Packaged diet foods may appear to be healthy, but they also contain preservatives, sugars, additives, and artificial sweeteners (source). A lot of these ingredients are hard to digest and may cause inflammation. You really can’t go wrong by eating a variety of fresh and cooked veggies, fruits, nuts and seeds, cold-pressed oils like olive, avocado and coconut and quality proteins. Wild caught salmon, which contains Omega-3’s, has been linked to lower androgen levels (source).
Nurture Your Inner Peace
Sleep deprivation can lead to insulin resistance and stress causes high cortisol levels. In high amounts, both of these hormones are linked to weight gain, and both can exacerbate symptoms of PCOS. So instead of staying up late to work and waking up at the crack of dawn to fit in a workout, try setting an electronics curfew and get some extra Zzzz’s! Focus on stress-management on the daily. Incorporate what works for you, be it meditation, walking outdoors, snuggling your kitty, or dancing in your apartment!
Re-Think Your Workout
Stop lifting tires, please! There is actually a recommended way to workout if you have PCOS, and intense cardio like running is not one of them. Try high intensity interval training, walking, or yoga. It seems counter-intuitive, but you can actually gain weight by doing the wrong kind of workout, especially when you’re trading sleep to get to the gym.
Find the Right Practitioner
Every body is different and a tailored plan can be key to help you in managing your PCOS symptoms. There are many different kinds of PCOS and thus there are different treatment methods for the same condition! Ask lots of questions to determine if one practitioner or another is right for you. Some questions to consider:
-What hormones do you test to diagnose PCOS? You’ll want to look for someone who tests estrogen, progesterone, insulin, androgens, luteinizing hormone, and even thyroid hormones.
-What is your treatment plan for someone with PCOS? Someone who understands how diet and lifestyle greatly impacts PCOS will recommend dietary changes, exercise, and things like sleep and stress management techniques.
-What other experts might you refer me to? A practitioner who understands PCOS might refer you to a nutritionist, endocrinologist, reproductive or fertility specialist, a therapist, and even a physical therapist, depending on your symptoms.
-What should I know going forward? Depending on the outcome of your treatment, you want to be sure your practitioner is going to have a plan to support your health long term. You don’t just want to be handed labs and then sent on your merry way. That isn’t helpful.
Why Are Some Women with PCOS Thin?
Some women with PCOS do not experience weight gain but may experience other symptoms. As I said before, there are several types of PCOS. We have different hormonal systems that all interact with each other in different ways. When one is thrown off balance, others can be thrown off balance and this can present as different symptoms. For example, some women with PCOS have more inflammation triggered by stress, environmental factors, or dietary choices while others are more prone to insulin-resistance.
However, it is still crucial to maintain a nutrient-dense diet and prevent weight gain. While research suggests that obesity does not cause PCOS, gaining weight can worsen symptoms of PCOS for women that already have it (source).
In my experience, PCOS has been the motivating factor for me to eat well, stress less, sleep more, and be accepting of my body and its nuances. Instead of focusing on all of the symptoms that come along with PCOS, let it teach you how to nurture your body. Your body will tell you what it needs if you just give it a listen!
Photo by Sebastian Voortman.